Abstract
Elevated serum urate (sUA) concentrations have been associated with an increased risk of hypertension. We aimed to examine the association of sUA concentration on the risk of hypertension in pre- and post-menopausal women and investigated the association between the polymorphism of the xanthine dehydrogenase gene and the risk of hypertension. Among 7294 women, 1415 premenopausal and 5879 postmenopausal women were recruited. Anthropometric parameters as risk factors of hypertension were identify by logistic regression models. In addition, we investigated an association between xanthine dehydrogenase gene and sUA and their combined associations on the risk of hypertension. Body mass index (BMI) and waist circumference (WC) were significantly increased in accordance to the increase of sUA levels (p < 0.001). Multivariate logistic regression analysis showed postmenopausal women with a high sUA and high BMI were 3.18 times more likely to have hypertension than in those with normal and lower sUA (Odds ratio: 3.18, 95% confidence interval: 2.54–3.96). Postmenopausal women with a high WC were 1.62 times more likely to have hypertension than in those with normal and lower sUA. Subjects with the AG genotype of rs206860 was found to be at lower risk of hypertension (odd ratio: 0.287, 95% confidence interval: 0.091–0.905, p = 0.033). This cross-sectional study indicated a high sUA is associated with a higher risk of hypertension in postmenopausal women. Further well-designed prospective studies in other populations are warranted to validate our results.
Highlights
An elevated serum urate concentration is a common phenomenon in subjects with hypertension, insulin resistance, or obesity [1], and previous epidemiological studies have demonstrated that high sUA concentrations are associated with an increased risk of hypertension [1,2,3,4,5]
The percentages of Body mass index (BMI), systolic blood pressure (SBP), fasting glucose, and TG were significantly higher, and high-density lipoprotein (HDL) cholesterol were significantly lower in the highest quartile of sUA (UA ≥ 5.0 mg/dL) (Table 1)
In the beginning of study design, we analyzed an association of sUA and hypertension with substantial confounding factors that related with sUA such as BMI and alcohol consumption
Summary
An elevated serum urate (sUA) concentration is a common phenomenon in subjects with hypertension, insulin resistance, or obesity [1], and previous epidemiological studies have demonstrated that high sUA concentrations are associated with an increased risk of hypertension [1,2,3,4,5]. Longitudinal studies showed sUA might play a role in the development of hypertension, the association between sUA and blood pressure may be affected by various factors [5,6,7]. It is not clear whether urate elevation is the cause or a consequence of hypertension [1,6,8]. SUA concentrations seem to be increased in both physiologic and post-surgical menopause independently of other confounders [9,17], presumably due to the uricosuric effect of estrogens and hormone replacement therapy induced sUA reduction [18]. To the best of our knowledge, urate production has a limited influence on sUA concentration and both, urate concentration and the production, might influence blood pressure by a different underlying mechanism
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